Kinship, Nuptiality and Child Health Outcomes in a Low Income Urban Area

项目概要 尽管在改善儿童生存方面取得了重大进展，撒哈拉以南非洲地区仍然存在一些问题 对儿童的身体成长和儿童早期发展来说最糟糕的结果。这在很大程度上是由 生活在低收入城市社区的儿童面临更高的风险。鉴于研究重点是 环境因素、社会经济地位和获得服务的机会，更不用说在这些方面投入的努力了 了解婚姻中快速的社会转型和亲属的角色如何影响儿童的福祉 这些社区。在这个项目中，我们在 NICHD R21 项目成功的基础上开发和测试 亲属支持树 (KST)，用于评估亲属对单亲母亲及其子女的支持的数量和质量 肯尼亚内罗毕贫民窟的儿童。所提出的混合方法，纵向研究开发了 工会正规化的新措施，以审查亲属支持、工会正规化之间的关系 和婴儿/儿童发育结果。工会正规化措施将捕捉这一过程 在社会和/或法律上承认工会。该研究将在 KST 项目的同一地点进行。 该站点拥有一个健康和人口监测系统 (HDSS)，有助于初始样本选择 并提供强大的基础设施。我们将进行严格的认知测试来最终确定有关工会的问题 形式化，验证现有的关系质量量表并在第一年预先测试所有工具以告知 调查的发展。然后，我们将从 1250 名 0 至 24 个月的儿童以及 18 至 29 岁的母亲开始 三年内每年收集两次有关儿童、母亲和选定亲属的数据。 kin 的数据包括 居住地和距离的地理空间指标以及亲属关系支持的多个领域。这将是 每年对母亲、亲生父亲和当前的子样本进行一次定性随访作为补充 合作伙伴。我们的分析将重点关注工会正规化和亲属关系支持对儿童的直接影响 结果以及一组已知与儿童发展相关的中间结果。我们 将使用交叉滞后的结构方程和增长模型来检验联合正规化和 随着时间的推移，亲属关系对儿童身体成长和儿童早期发展 (ECD) 的支持。我们还将 评估结合正规化在多大程度上缓和了亲属关系支持对身体成长的影响，以及 ECD 结果和亲属关系支持调节结合正规化对身体生长和 ECD 的影响 结果。我们将使用有调节的中介模型来实现这一目标。研究的最终目标是 确定为弱势母亲和幼儿提供最佳保护的家庭支持模式。

Project Summary Despite significant progress in improving child survival, sub-Saharan Africa continues to have some of the worst outcomes for children’s physical growth and early childhood development. This is driven in large part by elevated risks for children living in low-income urban communities. Whereas research has focused on environmental factors, socioeconomic status and access to services, much less effort have gone into understanding how rapid social transformation in marriage and the role of kin impacts children’s well-being in these communities. In this project, we build on the success of an NICHD R21 project to develop and test the Kinship Support Tree (KST) to assess quantity and quality of support from kin to single mothers and their children in a slum context in Nairobi, Kenya. The proposed mixed methods, the longitudinal study develops a new measure of union formalization to examine the relationships among kinship support, union formalization and infant/child development outcomes. The union formalization measure will capture the process of recognizing unions socially and/or legally. The study will be carried out in the same site as the KST project. The site hosts a Health and Demographic Surveillance System (HDSS) which facilitates initial sample selection and provides strong infrastructure. We will conduct rigorous cognitive testing to finalize the questions on union formalization, validate existing relationship quality scales and pretest all instruments in the first year to inform the survey development. We will then start with 1250 children ages 0 – 24 months with mothers aged 18-29 and collect data on the children, mothers and selected kin two times per year over 3 years. Data on kin include geospatial indicators of residence and distance and multiple domains of kinship support. This will be supplemented with qualitative follow up once a year on a subsample of mothers, biological fathers, and current partners. Our analysis will focus on the direct effects of union formalization and kinship support on child outcomes as well as on a set of intermediate outcomes known to be associated with child development. We will use cross-lagged structural equation and growth models to examine the effects of union formalization and kinship support on children’s physical growth and early child development (ECD) over time. We will also assess the extent to which union formalization moderates the effect of kinship support on physical growth and ECD outcomes and kinship support mediates the effect of union formalization on physical growth and ECD outcomes. We will use moderated mediation models to accomplish this. The ultimate goal of the study is to identify models of family support that offer optimum protection for vulnerable mothers and young children.